Category: News
Speech Recognition from Audrey to Alexa – A Brief History
Speech Recognition is a technology that has fascinated and disappointed doctors for more than 25 years. Dictate IT has been developing Speech Recognition solutions in our AI labs since 2014 and outlined here is a brief history of the science behind the technology and a reflection on why it might be the right time to give it a second look.
The ability for machines to recognise and respond to human speech has been a desire since the outset of computing. Early computer scientists wished they could interact with their creations as they did with their colleagues – by talking.
The Post War Period – The birth of the Computer Age
The first machine capable of recognizing human speech was invented in 1952 and named ‘Audrey’ by Bell Labs in the US. She could recognise spoken numbers from 1 to 9. Ten years later, IBM released ‘Shoebox’ which had the ability to recognise simple calculations and input them into a calculator. In the UK, scientists worked to improve recognition using statistical information concerning allowable phonemes in English, and in the USSR they pioneered dynamic time warping to cope with variations in speaking speed. Ask typists in your surgery about the variations in the speed of speech patterns and you will understand the significance of this.
Progress Slows after a promising start
By the 1970s progress had slowed, hampered by the idea that to improve recognition, machines would need to ‘understand’ speech, something that turned out to be unnecessary for the task of recognition and something which still eludes us today.
The late 70s and early 80s saw the introduction of two key new approaches: n-gram language models and Hidden Markov Models (HMMs).
N-gram language models describe the probability of a sequence of words, and are often contextual dependant. For example in the medical dictation domain, the tri-gram “This charming gentleman” is more likely than “This charming pineapple”. This probability allows speech recognition to go beyond just the phonetic information in the audio.
Hidden Markov Models are variants of techniques developed in the 1960s to aid prediction in the US defence industry, in turn based on maths outlined by the Russian Andrey Markov in the middle of the 20th century. Markov models aim to simplify prediction of a future state by only using the current state, rather than needing to use many prior states. Adoption of HMMs for speech recognition, coupled with the increases in computer power needed to feasibly run them produced huge leaps in accuracy and vocabulary size. HMMs continued to dominate speech recognition approaches for the next 25 years.
During the 90s and 00s, the PC enabled HMM-based speech recognition to become more widely available to consumers. Accuracy continued to improve, though began to plateau in the early 00s and still required a degree of per user training and manual correction, based on a speaker-dependent individual profile. Thus speech recognition acquired a slightly jaded reputation as being ‘not quite good enough’ for normal usage. When you last tried speech recognition on your PC to dictate a medical report you probably used a system that used an HMM acoustic model. The results would have been interesting – but not good enough and you probably concluded that it was not for your practice.
Enter the Neural Network and Machine Learning
Artificial Neural Networks (ANNs) were first described in the 1940s, and are networks of nodes and connections inspired by the workings of biological neurons. As with real neurons, as the network ‘learns’ some connections between nodes become stronger, some weaker. The difference from classic computer programming was that ANNs ‘learn’ by themselves rather than being driven entirely from hand-crafted rules given to them by their human programmers. It wasn’t until the 1980s that computing power was sufficient to realise the theoretical technique and interest in neural networks surged with hopes of (strong) Artificial Intelligence based on this biological model. The concept was applied to tasks like speech recognition, but without much success compared to the dominant HMMs. General interest in ANNs declined.
However, in the early 00s, a specific kind of ANN method called Deep Learning began to emerge as a potentially superior alternative. In particular, a collaboration between researchers at Google, Microsoft, IBM, and the University of Toronto showed how Deep Learning techniques could bring significant improvements to many areas including speech, image, and handwriting recognition.
Deep Learning uses Neural Networks that are ‘deep’ by virtue of having multiple layers of nodes between their input and output layers. In speech recognition the input being a segment of audio and the output a piece of text. Each layer ‘learns’ to transform the input to the output in a slightly different way. In 2009 a researcher at Google realised that by using Graphics Processing Units they could massively speed up the training of Deep Neural Networks (DNNs), dramatically shortening the time taken to experiment with new models. By 2012 it was clear that DNNs were outperforming old approaches in multiple fields and this kicked off the huge industry interest and public awareness about the use of ‘AI’.
DNNs are now used by all the major consumer speech recognition products you may be familiar with: Siri, Alexa, Cortana, Google Home/Nest, etc.
Dictate IT Neural Net Stack
Dictate IT began developing its own Deep Neural Network-based speech recognition in 2014. We have always focused on UK medical report recognition. The state of the art is changing constantly, but we currently use two kinds of neural networks:
- An acoustic model based on a factorised Time-Delay Neural Network (TDNN-F)
- An AWD-LTSM language model (aka an ASGD Weight-dropped Long Short Term Memory model
This allows us to provide unmatched highly-accurate speech recognition for UK medical dictation, with no training period required, while covering a wide range of the accents found in the NHS. If you’ve not used medical speech recognition in the last few years, we think you will be impressed by the improvements in the field.
Contact us for a free trial
University Hospital Plymouth NHS Trust goes live with Bluespier Theatres across entire Trust.
Bluespier Theatres was successfully implemented on 10th February 2021 across all theatres at the Trust replacing paper processes. The new electronic approach ensures surgical information is captured electronical in real time as part of current theatre workflows. Bluespier has been integrated with the current IPM PAS to ensure scheduling is standardised, can be completed accurately and at ease for a seamless user experience.
The implementation was a great success, given the challenges on the NHS caused by the current pandemic and the go live being in the mist of the largest peak and national lockdown.
Following an initial 6–8 weeks where the system is embedded at the Trust, Phase 3 will commence, where additional functionality will be implemented and further clinical benefits realised.
Cindy McConnachie, Senior Matron at University Hospital Plymouth, said: “Bluespier Theatres will allow us to commit further to safeguarding patients on surgical pathways. The whole change management process has not been without its challenges… despite this we have made the change and rapidly.
The support of the team at Bluespier has been outstanding. We were supported every step of the way, challenged when we had doubts. The Bluespier team ensured our transition onto Bluespier was made with minimal interruption to services and that patient safety was maintained.
We look forward to continuing to work with Bluespier and would like to thank them for the ongoing support of our teams. We also look forward to realising all the potential that Bluespier Theatres can bring to our service in the future.”
Stuart van Rooyen, Managing Director of Bluespier, said: “We are delighted to have been selected to provide our theatre management software to Plymouth and are proud of the seamless rollout despite the additional operational challenges due to the global pandemic. I’m grateful for all the additional time and resource the Trust have given this project on top of existing workload in what has been an extremely challenging time for NHS staff. I’m excited to continue working with the Trust to implement further phases and build on the great relationship we have.”
Lunch and Learn Webinar Series
My Aged Care e-Referrals free up precious time for healthcare workers
From one end of Australia to the other, My Aged Care e-Referrals are saving health professionals precious time so they can focus on what really matters – looking after patients.
The Australian Government’s My Aged Care service is the entry point for older Australians to access government-funded aged care. General practices play a key role in supporting patients to access these services.
My Aged Care introduced e-Referrals to support practices by making the process easier for healthcare workers around the country to refer their patients for an aged care assessment.
Chandler’s Hill Surgery near Adelaide in South Australia was part of the 2019 pilot programme trialling My Aged Care e-Referrals (which are powered by HealthLink) and has continued using them ever since.
Nurse manager Casey Franchi, who’s worked at Chandler’s Hill Surgery for five years, uses e-Referrals on a regular basis. The surgery uses the Best Practice PMS (practice management system).
“They are so easy to use and save so much time. All the patient details are pre-populated, which makes filling it out so much faster, more accurate and more efficient.”
Prior to e-Referrals, Casey used the My Aged Care website to send referrals.
“The website referral is time-consuming compared to e-Referrals because you have to manually type all the patient details in from their file, which can also lead to transcription errors.”
Casey says e-Referrals are so quick and easy to use, she can fill them out during a patient consultation and ask the patient questions while they are there.
“With the website, because it was time-consuming, I’d have to fill the referral out after the patient had left because it required a big chunk of my time to do it. And then if I needed to ask them a question, I’d have to contact them.”
Another benefit of e-Referrals is how easy it is to attach files.
“The e-Referral is in the patient file so you can easily and securely access any documents to upload to back up the referral.”
She says she can’t imagine life without e-Referrals.
“Life is so much easier now and I would recommend them to any general practice. The time saved means I can focus on the important stuff like caring for patients and not on filling out forms.”
My Aged Care director of online services and communication Kylie Sauer says e-Referrals have improved healthcare workers’ experience by offering better integration into their existing workflow and taking away the need to exit their PMS to send a referral.
“Sending a referral by fax or the My Aged Care website takes longer. By pre-populating patient information and GP details, e-Referrals are the fastest and most efficient way to refer patients to My Aged Care,” she says.
“Faxes are particularly slow to process, which results in patients waiting longer to be referred for an assessment.”
Warragul Family Medicine also saving precious time
Warragul Family Medicine in Victoria, which also uses Best Practice, has been using My Aged Care e-Referrals since December 2019.
Allied health assistant and medical receptionist Marcia Rollinson previously sent referrals via the My Aged Care website but can’t imagine going back to that method.
“I love e-Referrals. The pre-population of patient details is fantastic and saves me so much time. That’s the best part of the form because it’s so quick and easy.”
She also likes that e-Referrals are automatically saved back into the patient file.
“Previously, I’d have to save it externally somewhere or print it out and have a hard copy file, which was a hassle and not very secure.”
Being able to easily track back electronically to see when an e-Referral was sent is another bonus.
“Previously I’d have to try to think back or go through hard copy files, which was a pain.”
Marcia works two-and-a-half days a week and estimates she saves about an hour a week by using e-Referrals.
She also likes that she’s prompted if she misses a tab that needs to be filled out.
“For some reason there’s one tab I always forget to fill out, but it always prompts me at the end to fill it out, so nothing is missed.”
Did you know?
My Aged Care e-Referrals take about 5 minutes to complete and are processed instantly once successfully submitted. This makes e-Referrals the quickest and easiest way to refer patients to My Aged Care.
Here are our user guides which will help you get started:
Best Practice
Medical Director Clinical
Genie Solutions
Medtech Evolution (User guide coming soon)
For more information or technical support regarding the e-Referral forms, please contact the HealthLink help desk on 1800 125 036 (Option 4) or email helpdesk@healthlink.net
For more information about My Aged Care, please visit https://www.myagedcare.gov.au/health-professionals
The Importance of Email Security
E-mail scams have become more and more sophisticated, and we at DGL Practice Manager are increasingly concerned about protecting our customers and their understanding of email security. We can put as many sophisticated scanners, anti-virus programs and spam filters in place but sometimes a rotten apple will sneak through with the good ones.
The way to ensure that nothing malicious happens when that bad e-mail does sneak in is to make sure that you and your colleagues are fully aware of best practices in email security. To help, we’ve put together a simple guide below which you can share with your staff and colleagues.
E-mail Security guide:
Follow the simple rules below, and you’ll drastically reduce the risks associated with emails scams:
- The sender is crucial – If you don’t recognise the name of the sender, DO NOT open the e-mail. Just delete it.
- Ignore the unexpected – E-mail scams are clever pieces of social engineering, so they will often tell you that “You have a missed parcel” or “You’re due a rebate from HMRC”. If you’re not expecting a parcel, a tax rebate, or any other interesting sounding event then it’s probably a scam. Ignore it completely, unless you’re 100% sure it’s genuine (and then use extra vigilance)
- If you’re asked to open an attachment, don’t! – E-mails are a very easy way for nefarious people to spread viruses, especially when they have a brand new virus that’s not being detected by common anti-virus systems yet. If an e-mail you’re not expecting (or from someone you don’t know well) asks you to open an attachment, DO NOT open it. The most common dangerous e-mail attachments are .zip files – as they can contain executable/virus infected files.
- Don’t click strange links… or any links – To bypass spam and virus filters, the scammers will often send you an e-mail asking you to download a file/document online. DO NOT click these links. It’s also common to see scam financial/shopping e-mails, asking you to click through and confirm your details (these are known as phishing e-mails). Many e-mail security programs will not pick all of these up, and they are made to look just like an official e-mail from PayPal, or Amazon, or your bank. Once again, DO NOT click any links in these e-mails. If you need to visit or check your PayPal account, type the address into the top of your internet browser on your own local system and not within the DGL Hosted environment (www.paypal.com for example) rather than clicking through from an e-mail.
- If the e-mail seems fishy, odd, or too good to be true, then delete it
Additional Information: Clanwilliam Health (DGL) Ltd, would like to inform all users that the DGL Hosted Platform is provided as a service to manage your practice and is not intended for personal web browsing and/or email communications outside of normal business operations. We request that all personal activities are carried out on the users own personal and/or local PC systems to minimise any risk to your clinical data and the DGL network.
New Epilepsy NZ e-Referral solution goes live
Epilepsy New Zealand’s new e-Referral solution will make GPs and practice nurses’ lives a whole lot easier, says its chief executive Ross Smith.
E-Referrals can now be made to Epilepsy NZ using CareSelect.
“Prior to the new e-Referral solution, GPs had to go to our website, download a referral form, fill it out, scan it and then send it, which was very time consuming,” Ross says.
“The new e-Referral solution is quick and easy to use, so it will make life a lot easier for everyone involved.”
He says it is exciting to move from the old, clunky, time-consuming referral system to the new, fast electronic one.
“In this day and age, you have to have the ability to electronically make referrals and share health information. It just makes perfect sense.”
Epilepsy NZ is a nationwide charitable organisation that’s been supporting people with epilepsy since 1956.
Ross says a person can be diagnosed with epilepsy at any stage in their life.
“It’s life-changing. In many cases, you can no longer drive, and it can also affect your employment and other activities you would normally do.
Trained educators provide support
Epilepsy NZ employs a team of trained educators who provide free information, advocacy, education and support to people with epilepsy around New Zealand.
“Once a person has been diagnosed by their neurologist or GP, we continue the education and support. We’re part of the wider healthcare team and we get alongside the person and walk the journey with them.”
Epilepsy affects about 1% of the population and an estimated 48,000–50,000 people have epilepsy in New Zealand, Ross says.
“We would love to have more funding to do research on prevalence in New Zealand and the social impact it has, especially on children. There’s a lot of stigma and discrimination out there about epilepsy.”
Epilepsy New Zealand’s Purple Day is held on 26 March each year to raise awareness about epilepsy.
“Workplaces, community groups and schools can organise a local awareness day by holding a morning tea, mufti day or other event to help raise awareness,” Ross says.
How to refer to Epilepsy New Zealand:
- Open the patient record
- Select the HealthLink icon
- Use the CareSelect search bar, type “Epilepsy New Zealand”
- Click “Compose Referral”.
North Bristol NHS Trust goes live with Bluespier theatre management software to improve digital care
Bluespier Theatres was successfully implemented on 9th November 2020 across 32 theatres at the Trust replacing Galaxy DXC. The new electronic approach ensures clinical assessments are captured within Bluespier such as the WHO Checklist and the entire theatre care plans. Accurate scheduling, real time patient tracking, and theatre list cash up ensure the Trust is better able to monitor utilisation.
A ‘virtual go-live’ involving the Trust’s Scheduling team took place two weeks prior.
Both implementations were a real success, particularly given increased operational pressure on the NHS caused by the current pandemic and start of a second national lockdown. The Bluespier training team were onsite during the week of go-live, supporting Theatres staff alongside the North Bristol NHS implementation team.
A representative from the North Bristol NHS Trust Programmes team said: “Whilst it’s still early days for our Theatres and Schedulers teams working with Bluespier, we’re very pleased that this two-part go-live has gone smoothly. Providing ‘on-the-ground’ support was critical to this success and we’d like to thank Bluespier for their help with this as well as throughout the programme.”
Stuart van Rooyen, Managing Director of Bluespier, said: “We are extremely proud to be software partners with North Bristol NHS Trust and enormously thankful of all Trust and Bluespier staff who worked tirelessly to ensure a smooth rollout during these challenging times. We look forward to additional module rollouts, within the next few months.”
Mercy Radiology’s new digital scanner
Mercy Radiology’s new digital PET-CT scanner is the latest tool available in the fight against prostate cancer.
It was unveiled last month at Mercy Radiology’s new Milford clinic on Auckland’s North Shore. In New Zealand, prostate cancer is the most common cancer in men.
Mercy Radiology has 14 branches located around the wider Auckland area, offering a full spectrum of diagnostic radiology services.
Referrals to Mercy Radiology and Mercy Breast Clinic can now be made via CareSelect.
Clarity is everything
Mercy Radiology Group’s director of strategic programmes Alexis Stewart says the new digital PET-CT scanner provides better quality images compared to analogue scanners.
“This means cancers can be detected earlier and therefore treatment can begin earlier. If cancer is caught earlier, survivorship and quality of life can be greatly improved,” Alexis says.
PSMA scanning is also used to help detect cancers.
“Radioactive isotopes find and bind to the cancerous cells making it easier to pinpoint where the cancer is and if it has spread. This accurate information can then be used to help make the right and most effective treatment choices.”
Another new tool Mercy Radiology is using in the fight against prostate cancer is Lutetium therapy.
“Lutetium locks onto cancerous cells and leaves the healthy cells alone, which means less side effects compared to other palliative treatments like chemotherapy. Again, greatly improving our patients’ quality of life,” she says.
The therapy is currently used only for prostate cancer patients receiving palliative care, however new research from Australia is strongly suggesting it may be used for all prostate cancer patients in the future.
Early detection key: All 2D mammograms replaced
Alexis says Mercy Radiology recently replaced all its 2D mammogram machines with 3D tomosynthesis machines.
“The 3D imaging picks up more cancerous cells earlier than the 2D imaging, particularly for women who have dense breast tissue. Early detection is proven to improve survivorship.”
Mercy Radiology’s one-stop clinics are also helping in the fight against cancer by providing patient streamlined services and care that eliminates the need for multiple appointments over a long period of time.
“This fast-tracks the time to diagnosis by getting earlier detection and treatment. For some of our clinics, you can have your diagnosis and an initial treatment plan in as little as 45 minutes compared to the traditional two to six week wait,” she says.
How to refer Mercy Radiology Group:
Mercy Radiology have branches in the Auckland CBD, Botany, Epsom, Milford, Orewa, Pakuranga, Red Beach, Rosedale, Silverdale, St Lukes, Takapuna, Warkworth, and Westgate.
Refer to their central Booking Team who will make an appointment at the location most convenient to your patient.
- open the patient record
- launch the HealthLink homepage
- using the CareSelect search bar, type Mercy Radiology or Mercy Breast Clinic
- click “Compose Referral”.
Nottingham University Hospitals NHS Trust goes live with new electronic pre-operative process
Nottingham University Hospitals NHS Trust is driving forward its digital strategy by going live with a new electronic pre-operative process using Bluespier’s Fit For Surgery software.
The new electronic approach to pre-operative assessments is initially being used for colorectal patients as part of a phased roll-out period. The gynaecology department is set to adopt the new process in the summer with a wider Trust-wide roll out completed later in the autumn.
Pre-operative assessments for colorectal patients are now completed electronically by clinical staff in a paperless environment, with each patient’s Fit For Surgery status marked clearly within the system. These results are immediately visible to all relevant clinical teams through the care pathway via integration with Bluespier Theatres and the Trust’s EPR, Medway, creating a streamlined pre-op to theatre journey.
Stuart van Rooyen, Managing Director of Bluespier, said: “We are delighted for the Trust for this great step in their pre-operative process. This electronic approach will ensure all clinicians involved in the end-to-end theatre process have exactly the information they need at the right time, and will significantly benefit patients too.”
“We achieved a completely virtual Go Live of the colorectal department, including training and technical deployment, ensuring the Trust could deliver to their strict timescales whilst removing the need for onsite visits. This was a real success and an example of excellent communication, project management and comradery between both teams in a very challenging time for the NHS.
“We are proud to be ongoing software partners with Nottingham and look forward to continuing the roll out of this project over 2020.”
Lisa Lawrence, Head of Digital Products at NUH said “The go-live in Colorectal went incredibly smoothly given the significant challenges presented by Covid 19 and the need to deliver much of the support virtually. “
“Moving to an electronic pre-operative assessment has always been a key part of our Digital Strategy at NUH. The challenges posed by the pandemic have actually helped us to realise the benefits of moving towards an electronic system more quickly. A fully electronic process also supports the delivery of care offsite within local private provider premises, which enables clinical teams to review completed assessments from outside the clinical environment when necessary.
Electronic pre-operative assessment functionality also gives us visibility of where a patient is in the pathway – known as ‘Status at a Glance’. Staff can pre-populate information from existing systems, which is more efficient and improves patient safety. Staff also have the ability to pre-screen and stream patients ensuring that each patient receives the appropriate level of pre-op. There are prompts to support correct decision making by staff, thus benefiting patients.
We are looking forward to rolling out more widely over the coming months”.
About Bluespier:
Bluespier develops leading clinical systems for the NHS and private healthcare sector, helping healthcare providers deliver the best, cost effective patient care by utilising innovative technology. It specialises in software that supports theatres, trauma, pre-op, virtual clinics, anaesthetics and stock management.
Bluespier is part of the Clanwilliam Group. Clanwilliam Group is a collective of businesses using digital technology to connect people, processes and data globally to help achieve better patient outcomes.